Effectiveness of L-carnitine for the treatment of erythropoietin-resistant renal anaemia: A randomised, double-blind, placebo-controlled pilot trial

These findings provide evidence to support the National Kidney Foundation's practice recommendations with respect to the clinical use of L-carnitine for renal anaemia. Whilst the exact mechanism is yet to be elucidated, it is proposed that L-carnitine treatment improves carnitine palmitoyltransferase activity via carnitine pool normalization, thereby resulting in stabilization of the erythrocyte membrane. If this is the case, then it is feasible that a dual approach to increase erythrocyte production and lifespan through co-administration of ESA and L-carnitine provides a viable treatment option for ESA-resistant patients.